News in Brief: Week of Oct. 15-19

New Policy Brief Analyzes Pay-For-Performance Programs

Health Affairs and the Robert Wood Johnson Foundation have released a policy brief(www.healthaffairs.org) that analyzes pay-for-performance (P4P) programs in the public and private sectors and addresses both questions and concerns about the initiatives.

The brief provides a history of the initiatives and explains how P4P programs originally focused more on quality than cost control when they were initiated more than a decade ago.

Policy experts expect such programs to expand following passage of the Patient Protection and Affordable Care Act. The emergence of the payment model has raised a number of questions that will require more research and experimentation.

For example, how large do P4P rewards need to be to produce desired changes? How often should rewards be distributed? And how can improvements in performance be sustained over time? The authors concluded that long-term evaluations need to be conducted to identify any unintended consequences.

HHS Marks Investments in NHSC Program

According to an Oct. 11 press release(www.hhs.gov), the funding included nearly 4,600 loan repayment and scholarship awards to clinicians and students, as well as the provision of grants to 32 states to support state loan repayment programs.

NHSC enrollment has tripled since 2008 and now includes nearly 10,000 physicians and other health care professionals who provide care to about 10.4 million patients nationwide.

Close to 1,000 students, residents and health care professionals receive scholarships or participate in the Student to Service Loan Repayment program to prepare to practice.

California Enacts New Nurse Practitioner Prescribing Law

California recently enacted a law(www.leginfo.ca.gov) that amends two sections of the state's Business and Professions Code as related to nursing. The law eliminates the requirement of at least a six-month waiting period before a nurse practitioner or certified nurse-midwife can independently furnish or order drugs or medical devices.

Language in the new law authorizes physicians to determine the duration of supervision necessary.

The AAFP recently issued a report cautioning against training and employing nurse practitioners in place of physicians as a stop-gap answer to the nation's primary care physician shortage.

The exchange, the first in the nation to receive federal funding, is expected to reduce medical errors and duplication of services by facilitating the sharing of patient data. Experts say the exchange will save money and improve patient care. The $16.9 project is funded through a combination of Medicaid funds and money made available via the 2009 American Recovery and Reinvestment Act.